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Techniques for Percutaneous Access
Zachary Hale1, Austin Howard1, Yang Yang2
1Division of Cardiac Electrophysiology, Texas Heart Institute, Houston, TX, USA.
Cardiac Electrophysiology Clinics
|August 11, 2020
Summary
Percutaneous epicardial access, a key cardiac electrophysiology technique, is evolving. Innovations like micropuncture needles and advanced mapping reduce complications, while new access sites and imaging offer future potential.
Area of Science:
- Cardiac Electrophysiology
- Minimally Invasive Cardiac Procedures
Background:
- Percutaneous epicardial access is increasingly utilized in cardiac electrophysiology.
- The traditional method involves a Tuohy needle via a subxiphoid approach, relying on fluoroscopy and tactile feedback.
Purpose of the Study:
- To review the evolving landscape of percutaneous epicardial access.
- To highlight recent advancements and future directions in the field.
Main Methods:
- Review of current literature and emerging techniques in percutaneous epicardial access.
- Discussion of novel approaches including different access sites and advanced imaging.
Main Results:
- Recent developments include micropuncture needles, electroanatomic mapping, and pressure sensors to improve safety.
- Alternative access sites like the right atrial appendage are being explored.
Conclusions:
- Percutaneous epicardial access is a dynamic field with ongoing innovation.
- Future advancements may incorporate direct visualization, impedance monitoring, and virtual imaging for enhanced procedures.
